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Client Plan of Care with Nursing lnterventions and Goal(s)

Hlghest Priority

Nursing Diagnosis f1: evldenced by

Nursing lnterventlon fl: Delesatabblp/ N T6-Whom: (Clrcle) CN

Nursing lnterventlon #2: Monltor Deletatabb:O/ N To Whom: (Circle) CNA

Nursing lnterventlon S3: lmplemenvAdmlnlster oelegatabb$/ N To Whom: (Circle) CN,

Nursing lntervention lt4: Teach N \ oetegatabte: S/ N To Whom: (Circle) C

Goals: Short-term: By the end of the shift the patient will

Long-term: By dlscharge the patlent will


Evaluation: Patlent Short-term goal (Met/Not Met). Patient Long-term goal (Met/Not Met).

Medium Priority

Nursing Diagnosis #1: by ((Jl\eCIn{s(


Nursing lntervention #1: Assess N ToWhom: lGircle) CrrrA r$
Nurslng lntervention #2: Monltor N ToWhom: (Circle) Cnl r.(
./
Nursing lnterventlon #3: lmplement/Admlnister N Towhom: (Clrcle) CNI(IVN

Nursing lnterventlon ll4:


:
N To Whom: (Circle) CNA LIN
j
Goals: Short-term: 8y the end of the shift the patient will
Lont-term: By dlscharge the patient
Evaluation: Patient Short-term goal (Met/Not Met). Patlent Long-term goal (Met/Not

Lowest Priority

Nursing Diagnosis f1: evldenced by

Nursing lnterventlon #1: Delegatable: Y I N To Whom: (Circle) CNA wN RN


Nursing lntervention #2: Monitor. Delegatable: Y I N ToWhom: (Circle) CNA wN RN
Nursing lnterventlon #3: lmplement/Adminster (Frequency) Delegatable: Y I N To Whom: (Circle) CNA LVN RN

Nursing lntervention S4: Delesatable: Y I N To Whom: (Circle) CNA tVN RN


Goals: Short-term: By the end of the shlft the patient will

Long-term: By discharge the patlent wlll


Evaluation: Patient Short-term eoal (Met/Itot Met). Patient Lont-term toal (Met/Not Met)

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